Antimicrobials: Thienomycins aka "Penems" Flashcards
Thienamycins (“Penems”)
Broadest class of antibiotics
4 drugs of the penems
imipenem/cilastatin
ertapenem
meropenem
doripenem
MoA of penems
similar to PCNs/cephs, cell wall active
Penem cross allergy with PCN
5 - 10 %
common side effect of IV infusion: penems
nausea/vomiting
Benefit of penems
post antibiotic effect (PAE)
Thienamycins / “Penems” active against
most GP/GN aerobes EXCEPT MRSA and E. faecium
which aerobes are penems not active against
MRSA
E faecium
Penems in gram neg anaerobes
active against them, including B fragilis.
Meropenem
has the best activity against psuedomonas
ertapenem
has no psuedomonas activity but great against ESBLs.
ESBL
extended spectrum beta lactamases
FYI for imipenem/cilastatin
lowers seizure threshold in pts with CNS disease or decreased renal function.
Imipenem is always given with Cilastatin, why?
to prevent nephrotoxicity from imipenem by breaking down its toxic metabolites.
Penem for ESBLs
ertapenem
Penem for psuedomonas
meropenem
Distribution of thienamycins / “Penems”
widely distributed to body compartments, meninges, bile, bone, synovial fluid, most tissues.
dose reduce penems for
renal insufficiency
why check renal function before imipenem/cilastatin if cilastatin blocks nephrotoxicity?
if renal function is compromised, imipenem still may accumulate, lowering the seizure threshold.
what effect may you see with the ‘penems?
post antibiotic effect
drug of choice for ESBLs
‘penem
